January 9, 2004

Partners Telemedicine makes a difference in Cambodia

Partners HealthCare and the MGH have long been committed to helping not only local patients with illnesses and injuries, but also the greater community and beyond.
It is the "beyond"that has become a most significant commitment for the Partners Telemedicine program, which initiated a pilot program in 2001 called Operation Village Health.

This program has provided Partners Telemedicine the opportunity to test the benefits of remote medical consultations using Internet technology in some of the most depressed and deprived areas of the world. The program has reached out to remote regions with minimal access to health care, such as Rovieng and Ratanakiri in Cambodia.

In November, Joseph Kvedar, MD, founder and director of Partners Telemedicine (above with a young Cambodian patient), took a small group of MGH and Partners clinicians to Cambodia on a fact-finding tour to see how the pilot program affected people who truly are in need.

"It was an incredible trip,"says Kvedar. " It gave us an opportunity to witness firsthand the legacy of MGH physician Dr. Tom Durant, who committed his life to helping underserved nations like Cambodia."

The pilot program sent a traveling nurse on a six-hour journey to the remote village of Rovieng, where residents live in thatched-roof houses, and there is no running water or electricity. On monthly visits to the health center — which serves 4,000 people — the nurse triages patients, collects information and performs tests. The village health center has minimal capabilities — only three inpatient beds, two exam rooms, a family planning room, a sparsely-stocked pharmacy, and only one clinician who is a trained pharmacist.

The nurse relays the medical information through a portable solar powered Internet
service to doctors at the Sihanouk Hospital Center of HOPE, the closest hospital. The information also is sent to specialists at the MGH and BWH who offer medical advice.

According to Kvedar, the pilot program has had a significant impact on the villagers so far. Many of the patients who come to the health center have chronic illnesses that require follow-up visits and medications that villagers were not getting before the
program. Now patients with illnesses such as diabetes or hypertension can have access to the appropriate care. "It really is inspiring to see how well these patients are doing now," says Kvedar.

The program also is training some local Cambodians to provide basic medical care to patients with minor problems. "This keeps the health care local and can prevent patients with minor illnesses from having to travel two hours to the local hospital," says Kvedar.

Since February 2003, Partners Telemedicine has expanded the pilot program to include a partnership with the Ratanakiri Hospital, a free-care hospital run by Cambodians. The hospital has more resources than the Rovieng health center, including more sanitary conditions, a staff of trained clinicians and a more efficient medical system. Operation Village Health offers additional training for the clinicians using telemedicine links as well as textbooks and other materials.

"This is a great example of how Partners Telemedicine can help remote areas of the world that don't have access to adequate medical care," says Kvedar. "All of the Partners clinicians who have participated in this pilot program have been very committed to it, providing their expertise for free. They all want to give back in some way."

In the next few years, Partners Telemedicine hopes to expand the program to offer more services to other villages in Cambodia.